Doctor Name: | JOSE L PACHECO |
NPI Number: | 1447622022 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | A23156 |
Business Practice Address: | 26457 Puffin Pl Canyon Country, CA - 913876390 |
Business Phone Number: | 6612982727 |
Business Fax Number: | 6612527373 |
Mailing Address: | Po Box 3196, CANYON COUNTRY |
State: | CA |
Postal Code: | 913863196 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/22/2015 |
NPI Last Update Date: | 10/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A23156 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |